Medical Disorders Related to Diving

Abstract

Exposure to the underwater environment is associated with several unique disorders that may require recompression in a hyperbaric chamber. Increasing pressure during descent reduces the volume of the paranasal sinuses and middle ear, which, if not properly equalized, will sustain injury due to barotrauma. Barotrauma of the inner ear results in vertigo, tinnitus, and often permanent hearing loss. During ascent, expanding gas can produce lung injury accompanied by pneumothorax, mediastinal and subcutaneous emphysema, injection of air into the pulmonary veins, and arterial air embolism to the brain. Divers with pulmonary barotrauma often present with unconsciousness, seizures, or other evidence of cerebral dysfunction. Rapid treatment with recompression often reverses the cerebral deficits. Air embolism lesions are usually diffuse, in contradistinction to a stroke which usually follows the distribution of a single cerebral artery. Decompression sickness is a disorder caused by evolution of supersaturated dissolved gas in tissues and blood following exposure to increased pressure. Protocols for avoiding excess supersaturation during ascent from depth have been available for more than 100 years, and diving is considered safe when established decompression schedules are followed. Decompression sickness causes pain in the joints of the upper and lower extremities, and can injure the spinal cord. Paralysis, paresthesias, sensory loss, and bowel and bladder paralysis accompany spinal cord injury. Treatment involves recompression and oxygen. Platelet inhibitors and other anti-inflammatory drugs are also useful. A diving disorder must be considered in any patient with a neurologic syndrome, vertigo, hearing loss, or joint pain following diving.

Bonding durability of custom-made mouthpiece for scuba diving after water storage under pressure

“…In recent years, the number of scuba divers has been growing 1) . However, scuba diving may trigger problems in some parts of the body such as the nose, ear, lung, and temporomandibular joint [2][3][4][5][6] . Previous studies reported that the prevalence of temporomandibular disorders while scuba diving ranged from 24% to 68% [7][8][9][10] .…”

Acute kidney injury due to decompression illness

“…The diagnosis of decompression illness is made on clinical grounds since gas bubbles are rarely detectable on imaging [ 1 ]. The most common symptoms of decompression sickness are localized pain, numbness/paresthesia and muscular weakness, typically presenting within the first 24 h, whereas symptoms of air embolism from pulmonary barotrauma occur immediately upon ascent [ 4 , 5 ]. Although no diagnostic blood test exists for air embolism, widespread air embolization has been reported to result in elevated serum creatine kinase of up to 900 U/L [ 6 ], as was the case in our patient.…”

Acute ischemic colitis secondary to air embolism after diving

“…The most common clinical manifestations result from gas emboli to the brain which can occur on ascent and produce syncope. [ 9 ]…”